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Subchapter 001: HEALTH INFORMATION TECHNOLOGY
§ 9351. Health Information Technology Plan
(a)(1) The Department of Vermont Health Access, in consultation with the Department’s Health
Information Exchange Steering Committee, shall be responsible for the overall coordination
of Vermont’s statewide Health Information Technology Plan. The Plan shall be revised
annually and updated comprehensively every five years to provide a strategic vision
for clinical health information technology.
(2) [Repealed.]
(3)(A) The Department, in consultation with the Steering Committee, shall administer the
Plan.
(B) The Plan shall include the implementation of an integrated electronic health information
infrastructure for the sharing of electronic health information among health care
facilities, health care professionals, public and private payers, and patients. The
Plan shall provide for each patient’s electronic health information that is contained
in the Vermont Health Information Exchange to be accessible to health care facilities,
health care professionals, and public and private payers to the extent permitted under
federal law unless the patient has affirmatively elected not to have the patient’s
electronic health information shared in that manner.
(C) The Plan shall include standards and protocols designed to promote patient education,
patient privacy, physician best practices, electronic connectivity to health care
data, access to advance care planning documents, and, overall, a more efficient and
less costly means of delivering quality health care in Vermont.
(D) A representative of the Green Mountain Care Board shall be a voting member of the
Steering Committee.
(b) The Health Information Technology Plan shall:
(1) support the effective, efficient, statewide use of electronic health information in
patient care, health care policymaking, clinical research, health care financing,
and continuous quality improvements;
(2) educate the general public and health care professionals about the value of an electronic
health infrastructure for improving patient care;
(3) ensure the use of national standards for the development of an interoperable system,
which shall include provisions relating to security, privacy, data content, structures
and format, vocabulary, and transmission protocols;
(4) propose strategic investments in equipment and other infrastructure elements that
will facilitate the ongoing development of a statewide infrastructure;
(5) recommend funding mechanisms for the ongoing development and maintenance costs of
a statewide health information system, including funding options and an implementation
strategy for a loan and grant program;
(6) incorporate the existing health care information technology initiatives to the extent
feasible in order to avoid incompatible systems and duplicative efforts;
(7) integrate the information technology components of the Blueprint for Health established
in chapter 13 of this title, the Agency of Human Services’ Enterprise Master Patient
Index and all other Medicaid management information systems being developed by the
Department of Vermont Health Access, information technology components of the quality
assurance system, the program to capitalize with loans and grants electronic medical
record systems in primary care practices, and any other information technology initiatives
coordinated pursuant to 3 V.S.A. § 3027; and
(8) address issues related to data ownership, governance, and confidentiality and security
of patient information.
(c) The Department of Vermont Health Access, in consultation with the Steering Committee,
may propose updates to the Plan in addition to the annual updates as needed to reflect
emerging technologies, the State’s changing needs, and such other areas as the Department
deems appropriate. The Department shall solicit recommendations from interested stakeholders
in order to propose updates to the Health Information Technology Plan pursuant to
subsection (a) of this section and to this subsection, including applicable standards,
protocols, and pilot programs, and may enter into a contract or grant agreement with
appropriate entities to update some or all of the Plan. The Department of Vermont
Health Access shall distribute the updated Plan to the Secretary of Administration;
the Secretary of Digital Services; the Commissioner of Financial Regulation; the Green
Mountain Care Board; the Secretary of Human Services; the Commissioner of Health;
the Commissioner of Mental Health; the Commissioner of Disabilities, Aging, and Independent
Living; the Senate Committee on Health and Welfare; the House Committee on Health
Care; affected parties; and interested stakeholders. Unless major modifications are
required, the Department may present updated information about the Plan to the legislative
committees of jurisdiction in lieu of creating a written report.
(d) The Health Information Technology Plan shall serve as the framework within which the
Green Mountain Care Board reviews certificate of need applications for information
technology under section 9440b of this title. In addition, the Secretary of Digital Services shall use the Health Information
Technology Plan as the basis for independent review of State information technology
procurements.
(e) The privacy standards and protocols developed in the Statewide Health Information
Technology Plan shall be no less stringent than applicable federal and State guidelines,
including the “Standards for Privacy of Individually Identifiable Health Information”
established under the Health Insurance Portability and Accountability Act of 1996
and contained in 45 C.F.R., Parts 160 and 164, and any subsequent amendments, and the privacy provisions established under Subtitle D of Title XIII of Division A of the American Recovery and Reinvestment Act of 2009, Pub. L. No. 111-5, § 13400 et seq. The standards and protocols shall require that access to individually identifiable health information is secure and traceable by an electronic audit trail.
(f) [Repealed.] (Added 2009, No. 61, § 1; amended 2009, No. 156 (Adj. Sess.), § I.25; 2011, No. 63, § G.103; 2013, No. 79, § 49b; 2015, No. 172 (Adj. Sess.), § E.306; 2017, No. 85, § F.9, eff. June 28, 2017; 2017, No. 187 (Adj. Sess.), § 2, eff. May 28, 2018; 2019, No. 53, § 4, eff. March 1, 2020; 2025, No. 18, § 27, eff. May 13, 2025; 2025, No. 62, § 1, eff. July 1, 2025.)
§ 9352. Vermont Information Technology Leaders
(a) Governance. The Vermont Information Technology Leaders, Inc. (VITL) Board of Directors shall consist
of no fewer than nine nor more than 14 members. The term of each member shall be two
years, except that of the members first appointed, approximately one-half shall serve
a term of one year and approximately one-half shall serve a term of two years, and
members shall continue to hold office until their successors have been duly appointed.
The Board of Directors shall comprise representatives of the business community, of
health care consumers, of Vermont hospitals, of Vermont-licensed clinicians, and of
health insurers licensed to offer plans in Vermont, as well as individuals familiar
with health information technology, including, to the extent practicable, one or more
individuals who are or have served as the chief technology officer for a health care
facility.
(b) Conflict of interest. In carrying out their responsibilities under this section, Directors of VITL shall
be subject to conflict of interest policies established by the Secretary of Administration
to ensure that deliberations and decisions are fair and equitable.
(c) Health information exchange operation.
(1) VITL shall be designated in the Health Information Technology Plan to operate the
exclusive statewide health information exchange network for this State. The Plan shall
determine the manner in which Vermont’s health information exchange network shall
be managed. Nothing in this chapter shall impede local community providers from the
exchange of electronic medical data.
(2) Notwithstanding any provision of 3 V.S.A. § 2222 or 2283b to the contrary, upon request of the Secretary of Administration, the Agency of Digital
Services shall review VITL’s technology for security, privacy, and interoperability
with State government information technology, consistent with the State’s health information
technology plan required by section 9351 of this title.
(d) Privacy. The standards and protocols implemented by VITL shall be consistent with those adopted
by the statewide Health Information Technology Plan pursuant to subsection 9351(e) of this title.
(e) Report. On or before January 15 of each year, VITL shall file a report with the Green Mountain
Care Board; the Secretary of Administration; the Secretary of Digital Services; the
Commissioner of Financial Regulation; the Commissioner of Vermont Health Access; the
Secretary of Human Services; the Commissioner of Health; the Commissioner of Mental
Health; the Commissioner of Disabilities, Aging, and Independent Living; the Senate
Committee on Health and Welfare; and the House Committee on Health Care. The report
shall include an assessment of progress in implementing health information technology
in Vermont and recommendations for additional funding and legislation required. In
addition, VITL shall publish minutes of VITL meetings and any other relevant information
on a public website. The provisions of 2 V.S.A. § 20(d) (expiration of required reports) shall not apply to the report to be made under this
subsection.
(f) Funding authorization. VITL is authorized to seek matching funds to assist with carrying out the purposes
of this section. In addition, it may accept any and all donations, gifts, and grants
of money, equipment, supplies, materials, and services from the federal or any local
government, or any agency thereof, and from any person, firm, foundation, or corporation
for any of its purposes and functions under this section and may receive and use the
same, subject to the terms, conditions, and regulations governing such donations,
gifts, and grants. VITL shall not use any State funds for health care consumer advertising,
marketing, or similar services unless necessary to comply with the terms of a contract
or grant that requires a contribution of State funds.
(g) Waivers. The Secretary of Human Services or designee, in consultation with VITL, may seek any
waivers of federal law, of rule, or of regulation that might assist with implementation
of this section.
(h) [Repealed.]
(i) Certification of meaningful use and connectivity.
(1) To the extent necessary to support Vermont’s health care reform goals or as required
by federal law, VITL shall be authorized to certify the meaningful use of health information
technology and electronic health records by health care providers licensed in Vermont.
(2) VITL, in consultation with health care providers and health care facilities, shall
establish criteria for creating or maintaining connectivity to the State’s health
information exchange network.
(j) Scope of activities. VITL and any person who serves as a member, director, officer, or employee of VITL
with or without compensation shall not be considered a health care provider as defined
in subdivision 9432 of this title for purposes of any action taken in good faith pursuant to or in reliance upon provisions
of this section relating to VITL’s:
(1) governance;
(2) electronic exchange of health information and operation of the statewide Health Information
Exchange Network as long as nothing in such exchange or operation constitutes the
practice of medicine pursuant to 26 V.S.A. chapter 23 or 33;
(3) implementation of privacy provisions;
(4) funding authority;
(5) application for waivers of federal law;
(6) establishment and operation of a financing program providing electronic health records
systems to providers; or
(7) certification of health care providers’ meaningful use of health information technology. (Added 2009, No. 61, § 1; amended 2009, No. 67 (Adj. Sess.), § 108; 2009, No. 156 (Adj. Sess.), § I.26; 2011, No. 63, § G.104; 2013, No. 79, § 34a, eff. June 7, 2013; 2013, No. 142 (Adj. Sess.), § 34; 2015, No. 54, § 9, eff. June 5, 2015; 2015, No. 172 (Adj. Sess.), § E.306.1; 2017, No. 187 (Adj. Sess.), § 3, eff. May 28, 2018; 2023, No. 6, § 223, eff. July 1, 2023; 2025, No. 62, § 2, eff. July 1, 2025.)
§ 9353. Integration of health care data; reports
(a) The Agency of Human Services shall collaborate with the Health Information Exchange
Steering Committee in the development of the Unified Health Data Space in order to
improve patient and provider access to relevant information, increase efficiencies
and decrease administrative burdens on providers, and reduce health care system costs.
(b) The Agency’s development of the Unified Health Data Space shall:
(1) align with the statewide Health Information Technology Plan established pursuant to
section 9351 of this title;
(2) utilize the expertise of the Health Information Exchange Steering Committee;
(3) incorporate appropriate privacy and security standards that are aligned with the best
privacy and security interests of patients;
(4) determine whether to integrate clinical data, claims data, data regarding social drivers
of health and health-related social needs, and other data types and, if so, how to
do so in a manner that protects proprietary information relating to payers and providers;
provided, however, that integration of these data types or a subset of them shall
not begin prior to January 1, 2027 and shall occur only upon the favorable vote of
a majority of all voting members of the Health Information Exchange Steering Committee
and only for the specific uses approved by a majority of all voting members of the
Steering Committee;
(5) if data is integrated in accordance with subdivision (4) of this subsection, limit
the use of the integrated data to the specific uses approved by the Health Information
Exchange Steering Committee;
(6) ensure interoperability among contributing data sources and applications to enable
use of the Unified Health Data Space;
(7) identify the resources necessary to complete data linkages for policy, health surveillance,
population health management, and research usage and for the data integration uses
approved by the Health Information Exchange Steering Committee pursuant to subdivisions
(4) and (5) of this subsection;
(8) establish a timeline for setup and access to the integrated system;
(9) develop and implement a system that ensures rapid access for patients and providers;
and
(10) identify additional opportunities for future development, including incorporating
new data types and larger populations.
(c) The Agency shall provide access to data to State agencies and health care providers
as needed to support the goals of the Statewide Health Care Delivery Strategic Plan
established pursuant to section 9403 of this title, once established, to the extent permitted by the data use agreements in place for
each data set and the uses approved pursuant to subdivision (b)(4) of this section.
(d)(1) On or before January 15, 2026, the Agency of Human Services shall report to the House
Committees on Health Care and on Human Services and the Senate Committee on Health
and Welfare regarding the advantages and disadvantages of integrating clinical data,
claims data, data regarding social drivers of health and health-related social needs,
and other data types in the Unified Health Data Space; how an integrated system can
improve patient and provider access to relevant information, increase efficiencies
and decrease administrative burdens on providers, increase access to and quality of
health care for Vermonters, and reduce health care system costs; and how an integrated
system can be implemented in a manner that protects proprietary information relating
to payers and providers.
(2) On or before January 15 annually beginning in 2027, the Agency of Human Services shall
provide an update to the House Committees on Health Care and on Human Services and
the Senate Committee on Health and Welfare regarding the development and implementation
of the Unified Health Data Space in accordance with this section. (Added 2025, No. 68, § 10, eff. June 12, 2025.)
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Subchapter 002: TELEHEALTH
§ 9361. Health care providers delivering health care services through telemedicine or by store-and-forward
means
(a) As used in this section, “distant site,” “health care provider,” “originating site,”
“store-and-forward,” and “telemedicine” have the same meanings as in 8 V.S.A. § 4098a.
(b) Subject to the limitations of the license under which the individual is practicing,
a health care provider licensed in this State may prescribe, dispense, or administer
drugs or medical supplies, or otherwise provide treatment recommendations to a patient
after having performed an appropriate examination of the patient in person, through
telemedicine, or by the use of instrumentation and diagnostic equipment through which
images and medical records may be transmitted electronically. Treatment recommendations
made via electronic means, including issuing a prescription via electronic means,
shall be held to the same standards of appropriate practice as those in traditional
provider-patient settings.
(c)(1) A health care provider delivering health care services or dental services through
telemedicine shall obtain and document a patient’s oral or written informed consent
for the use of telemedicine technology prior to delivering services to the patient.
(A) The informed consent for telemedicine services shall be provided in accordance with
Vermont and national policies and guidelines on the appropriate use of telemedicine
within the provider’s profession and shall include, in language that patients can
easily understand:
(i) an explanation of the opportunities and limitations of delivering health care services
or dental services through telemedicine;
(ii) informing the patient of the presence of any other individual who will be participating
in or observing the patient’s consultation with the provider at the distant site and
obtaining the patient’s permission for the participation or observation; and
(iii) assurance that all services the health care provider delivers to the patient through
telemedicine will be delivered over a secure connection that complies with the requirements
of the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191.
(B) For services delivered through telemedicine on an ongoing basis, the health care provider
shall be required to obtain consent only at the first episode of care.
(2) The provider shall include the patient’s written consent in the patient’s medical
record or document the patient’s oral consent in the patient’s medical record.
(3) A health care provider delivering telemedicine services through a contract with a
third-party vendor shall comply with the provisions of this subsection (c) to the
extent permissible under the terms of the contract. If the contract requires the health
care provider to use the vendor’s own informed consent provisions instead of those
set forth in this subsection, the health care provider shall be deemed to be in compliance
with the requirements of this subsection if he or she adheres to the terms of the
vendor’s informed consent policies.
(4) Notwithstanding any provision of this subsection to the contrary, a health care provider
shall not be required to obtain a patient’s informed consent for the use of telemedicine
in the following circumstances:
(A) in the case of a medical emergency;
(B) for the second certification of an emergency examination determining whether an individual
is a person in need of treatment pursuant to section 7508 of this title; or
(C) for a psychiatrist’s examination to determine whether an individual is in need of
inpatient hospitalization pursuant to 13 V.S.A. § 4815(g)(3).
(d) Neither a health care provider nor a patient shall create or cause to be created a
recording of a provider’s telemedicine consultation with a patient.
(e)(1) A patient receiving health care services or dental services by store-and-forward means
shall be informed of the patient’s right to refuse to receive services in this manner
and to request services in an alternative format, such as through real-time telemedicine
services or an in-person visit.
(2) Receipt of services by store-and-forward means shall not preclude a patient from receiving
real-time telemedicine services or an in-person visit with the distant site health
care provider at a future date.
(3) Originating site health care providers involved in the store-and-forward process shall
obtain informed consent from the patient as described in subsection (c) of this section. (Added 2011, No. 107 (Adj. Sess.), § 4, eff. May 8, 2012; amended 2017, No. 64, § 2, eff. Oct. 1, 2017; 2019, No. 91 (Adj. Sess.), § 25, eff. March 30, 2020; 2025, No. 11, § 17, eff. September 1, 2025.)
§ 9362. Health care providers delivering health care services by audio-only telephone
(a) As used in this section:
(1) “Health insurance plan” has the same meaning as in 8 V.S.A. § 4011.
(2) “Health care provider” has the same meaning as in 8 V.S.A. § 4098b.
(3) “Telemedicine” has the same meaning as in 8 V.S.A. § 4098a.
(b)(1) Subject to the limitations of the license under which the individual is practicing
and, for Medicaid patients, to the extent permitted by the Centers for Medicare and
Medicaid Services, a health care provider may deliver health care services to a patient
using audio-only telephone if the patient elects to receive the services in this manner
and it is clinically appropriate to do so. A health care provider shall comply with
any training requirements imposed by the provider’s licensing board on the appropriate
use of audio-only telephone in health care delivery.
(2) A health care provider delivering health care services using audio-only telephone
shall include or document in the patient’s medical record:
(A) the patient’s informed consent for receiving services using audio-only telephone in
accordance with subsection (c) of this section; and
(B) the reason or reasons that the provider determined that it was clinically appropriate
to deliver health care services to the patient by audio-only telephone.
(3)(A) A health care provider shall not require a patient to receive health care services
by audio-only telephone if the patient does not wish to receive services in this manner.
(B) A health care provider shall deliver care that is timely and complies with contractual
requirements and shall not delay care unnecessarily if a patient elects to receive
services through an in-person visit or telemedicine instead of by audio-only telephone.
(c) A health care provider delivering health care services by audio-only telephone shall
obtain and document a patient’s oral or written informed consent for the use of audio-only
telephone prior to the appointment or at the start of the appointment but prior to
delivering any billable service.
(1) The informed consent for audio-only telephone services shall be provided in accordance
with Vermont and national policies and guidelines on the appropriate use of telephone
services within the provider’s profession and shall include, in language that patients
can easily understand:
(A) that the patient is entitled to choose to receive services by audio-only telephone,
in person, or through telemedicine, to the extent clinically appropriate;
(B) that receiving services by audio-only telephone does not preclude the patient from
receiving services in person or through telemedicine at a later date;
(C) an explanation of the opportunities and limitations of delivering and receiving health
care services using audio-only telephone;
(D) informing the patient of the presence of any other individual who will be participating
in or listening to the patient’s consultation with the provider and obtaining the
patient’s permission for the participation or observation;
(E) whether the services will be billed to the patient’s health insurance plan if delivered
by audio-only telephone and what this may mean for the patient’s financial responsibility
for co-payments, coinsurance, and deductibles; and
(F) informing the patient that not all audio-only health care services are covered by
all health plans.
(2) For services delivered by audio-only telephone on an ongoing basis, the health care
provider shall be required to obtain consent only at the first episode of care.
(3) If the patient provides oral informed consent, the provider shall offer to provide
the patient with a written copy of the informed consent.
(4) Notwithstanding any provision of this subsection to the contrary, a health care provider
shall not be required to obtain a patient’s informed consent for the use of audio-only
telephone services in the case of a medical emergency.
(5) A health care provider may use a single informed consent form to address all telehealth
modalities, including telemedicine, store and forward, and audio-only telephone, as
long as the form complies with the provisions of section 9361 of this chapter and
this section.
(d) Neither a health care provider nor a patient shall create or cause to be created a
recording of a provider’s telephone consultation with a patient.
(e) Audio-only telephone services shall not be used in the following circumstances:
(1) for the second certification of an emergency examination determining whether an individual
is a person in need of treatment pursuant to section 7508 of this title; or
(2) for a psychiatrist’s examination to determine whether an individual is in need of
inpatient hospitalization pursuant to 13 V.S.A. § 4815(g)(3). (Added 2021, No. 6, § 5, eff. March 29, 2021; amended 2025, No. 11, § 18, eff. September 1, 2025.)